In emergency medicine circles, the "time is muscle" rule means that delays in treating a heart attack increase the likelihood that the heart muscle will be damaged due to inadequate oxygen. That’s why “door-to-balloon time,” the time measurement in the treatment of heart attack, is crucial. The interval begins with the patient’s arrival in the emergency department and ends when the patient’s balloon angioplasty is underway. When providing balloon angioplasty in an emergency, The Center for Cardiovascular Health’s average door-to-balloon time is about 70 minutes—20 minutes faster than the national recommendation for this procedure.

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Catheterization: Gary's Story

Gary Rosenberg will never forget that October Sunday in 2009. As he was about to return a serve on the paddleball court, a tightness gripped the center of his chest. He left the court to drive to his Bellmore home, when he began to sweat profusely. Then both arms felt "dead."
"I thought if I just relaxed a little, it would go away," he said. Within minutes of climbing into the shower, he vomited. The nausea was followed by shortness of breath. "I didn’t think I was dying," he said. "I had an ‘S’ on my chest; I thought I was Superman."

Once Mr. Rosenberg’s wife, Janie, arrived home, she called an ambulance, which transported Mr. Rosenberg, then 43, to South Nassau Hospital, where he was diagnosed with acute myocardial infarction. Before long, the gravity of the situation sank in.
Dr. Jason Freeman, Director of Interventional Cardiology, performed an angioplasty, which opens blocked coronary arteries with a balloon-tipped catheter. He also inserted a stent, a tiny netted tube, to prevent the clogged right coronary artery from closing. Within an hour after the procedure, Mr. Rosenberg was in a bed watching the New York Giants football game, feeling like a "million dollars."

"Mr. Rosenberg had a clot in one of his three coronary arteries, the right one, that feeds the heart," Dr. Freeman said. "We unblocked the artery and restored normal blood flow." An echocardiogram performed after his heart attack showed no damage to the heart. His prognosis is good, Dr. Freeman said.